Donald Scott House
Individual provider Active NPI General Practice Dentistry · Bellmead, TX
NPI 1114366390 · NPPES record last updated Jun 6, 2016
Key facts
- NPI
- 1114366390
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 29061 (TX)
- Practice address
- 121 Eastgate PLZ
Bellmead, TX 76705-2868 - Phone
- (254) 799-4867
- NPI assigned
- Jun 20, 2013
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160615000048 | MI | Order and Referring Only - Other (Physician) |
4082905476 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901021867 | MI | MD | Dentist |
| 29061 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Waco Family Dental PLLC | General Practice | Past |
Accepting new patients |
| Fusion Dental- Hewitt PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 29061 | TX | Yes |
| Dentist | 122300000X | 2901021867 | MI |
Addresses
Primary practice location
121 Eastgate PLZ
Bellmead, TX 76705-2868
Mailing address
10017 Desperado
Waco, TX 76708-6195
Phone (208) 520-0731
Other providers in Bellmead, TX
- Elizabeth Ann Marie Gibich
- Mellodiemolly Gibson
- Samuel John Gilbertson
- Brittany Greensage
- Heart of Texas Community Health Center, Inc.
- Jonathan Huo
- James T Shoptaw DDS
- Christopher F Johnson
- Paul Joseph Kitchens
- Sandra Kitson
All providers in Bellmead, TX · General Practice Dentistry in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.